NEW INSIGHTS INTO THE ETIOLOGY OF PREECLAMPSIA

Pre-eclampsia is a pregnancy-specific syndrome of unknown etiology, de fined by clinical findings of elevated blood pressure combined with pr oteinuria and oedema. The decidual portion of the spiral arteries of w omen who later develop pre-eclampsia does not undergo the normal pregn ancy-induced remodelling that converts these vessels to high volume-lo w resistance conduits. We have postulated that this failure leads to v ascular spasm, restricted blood flow, placental ischaemia and the rele ase of toxic substances that enter the maternal circulation, resulting in multi-organ disease. The complex and interwoven pathways of endocr ine, paracrine and autocrine factors appear to result in a vicious cyc le of endothelial cell dysfunction, which is expressed clinically as p re-eclampsia.